MEDICARE: DR. CADRIN EMMANUEL GILL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	G34954	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891851861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CADRIN EMMANUEL GILL MD

Provider Business Mailing Address
First Line	:	231 W VERNON AVE
Second Line	:	101
City	:	LOS ANGELES
State	:	CA
Zip	:	90037-2700
Country	:	US
Telephone Number	:	323-231-5181
Fax Number	:	323-231-9909

Provider Business Practice Location Address
First Line	:	231 W VERNON AVE
Second Line	:	101
City	:	LOS ANGELES
State	:	CA
Zip	:	90037-2700
Country	:	US
Telephone Number	:	323-231-5181
Fax Number	:	323-231-9909

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2006
Last Update Date	:	07/30/2010

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